Noblesville Schools Medical Plan 65 Section 2: Exclusions and Limitations and Resources. Some travel expenses related to Covered Health Care Services received from a Designated Provider or other Network provider may be paid back at the Claims Administrator's discretion. This exclusion does not apply to ambulance transportation for which Benefits are provided as described under Ambulance Services in Section 1: Covered Health Care Services. 2. Health care services provided in a foreign country, unless required as Emergency Health Care Services. Types of Care, Supportive Services, and Housing 1. Multi-disciplinary pain management programs provided on an inpatient basis for sharp, sudden pain or for worsened long term pain. 2. Custodial Care or maintenance care. 3. Domiciliary care. 4. Private Duty Nursing Inpatient. 5. Private Duty Nursing Outpatient. 6. Respite care. This exclusion does not apply to respite care for which Benefits are provided as described under Hospice Care in Section 1: Covered Health Care Services. 7. Rest cures. 8. Services of personal care aides. 9. Independent living services. 10. Assisted living services. 11. Educational counseling, testing, and support services including tutoring, mentoring, tuition, and school-based services for children and adolescents required to be provided by or paid for by the school under the Individual with Disabilities Education Act. 12. Vocational counseling, testing, and support services including job training, placement services, and work hardening programs (programs designed to return a person to work or to prepare a person for specific work). 13. Transitional Living services (including recovery residences). Vision and Hearing 1. Cost and fitting charge for eyeglasses and contact lenses except for the first pair following surgical removal of the lens(es) of the eyes. 2. Routine vision exams, including refractive exams to determine the need for vision correction. 3. Implantable lenses used only to fix a refractive error (such as Intacs corneal implants). 4. Eye exercise or vision therapy. 5. Surgery that is intended to allow you to see better without glasses or other vision correction. Examples include radial keratotomy, laser and other refractive eye surgery. 6. Cost and related fitting and testing charges for hearing aids, bone anchored hearing aids and all other hearing assistive devices. 7. Over-the-counter hearing aids.